USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1939 > Part 6
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To be complete, an occupation return must state :
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative," etc. Find out the partic- ular kind of work done and return that, as SPINNER, WEAVER, etc.
In stating the industry or business, avoid the use of such gen- eral ternis as "store," "factory," "mill," etc. State the particular kind of store, factory, mill, etc., as GROCERY STORE, SOAP FACTORY, COTTON MILL, etc.
Distinguish carefully the different. kinds of engineers by stating the full descriptive titles, as CIVIL ENGINEER, MECHANICAL ENGIN- EER, MINING ENGINEER, STATIONARY ENGINEER, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic," but give the exact occupation, as CARPENTER, PAINTER, MACHINIST, etc. Distinguish carefully between RETAIL MERCHANTS AND WHOLESALE MERCHANTS. A person who sells goods should be called a SALESMAN and not a CLERK.
Statement of Cause of Death. - Cause of death means the disease, or complication which causes death, NOT the mode of dying, E. G., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
The principal cause of death and related causes of importance in order of onset were as follows:
Date ol Onset
Arteriosclerosis
1915
.......
Chronic interstitial nepbritis ....
1921
Carebral hemorrhage
July 5, 1927
....
Contributory causes of importance not related to principal cause :
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first. second, or third position. The principal cause in the above example happens to be the second cause given.
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, alter the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, bis sup- posed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . . GEN. LAWS, CHAP. 46, SEC. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person ' died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, 'as re- quired by law, or in lieu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot be obtained early enough for the pur- pose,, or is insufficient, a physician who is a member of the hoard of health, or employed by it or by the selectmen for the purpose. . shall upon application make the certificate required of the attend. ing physician. If death is caused by violence, the medical examiner shall make such certificate.
If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was re- moved within thirty six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the l'nited States in any war in which it has been engaged. such recital shall ap- pear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith counter- sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death. which the clerk or registrar may require .- CHAP. 114, SEC. 45,, G. L. (TER- CENTENARY EDITION.)
Medical examinera shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. -GEN. LAWS, CHIAP. 38, SEC. 6.
.... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- GEN. LAWS, CHAP. 38, SEC. 7.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to he buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . .-- CHAP. 114, SEC. 46, G. L. (TERCENTENARY EDITION.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ob- servance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examinera will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septi- cemia), and by the action of chemical (drugs or poisons), thermal. or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
M R-302
Norfolk
PLACE OF DEATH
(County)
Quincy
(City or Town) Quincy City Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Quincy
(City or town making return)
Registered No.
48
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Axel J. Poterson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Residence. No.
20 Bellevue Avenue
.St., .............
. Ward,
Winthrop Mass.
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred
yrs.
mos.
days. How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
Whito
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed,
HUSBAND of
Oscor Olson
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
7
74
7
Months.
Days
If less than 1 day Hours ....... . Minutes
8 Trade, profession, or particular kind of work done, as spinnstorekeeper sawyer, bookkeeper, etc.
9 Industry or business in which work was done, as silk mShip Chandler store saw mill, bank, etc ..
10 Date deceased last worked at
11 Total time (years)
spent in this
occupation
12 BIRTHPLACE (City)
(State or country) Sweden
13 NAME OF
FATHER Androw P. Peterson
14 BIRTHPLACE OF
FATHER (City)
Sweden
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Sweden
Sobey
17
lirs. Irene Peterson/Daughter
(Address) Waldemar Ave. , Winthrop, Ma33.
(Registrar of city or town where death occurred)
· DATE FILED
Jan. 27
19.
39
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January 26, 1939
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
Jan ...... 2
19.39 to ........ Jan ....... 26
...
189
I last saw # ....... alive on ...
Jen.25
19.30., death is said
to have occurred on the date stated ab aty. .m. The principal canse of death and related causes of importance in order of · onset were as follows: Dateofonset
... Hypertensive heart disce-80-1-1-59. Uraemia
Contributory cances of importance not related to principal cause: Myocerditis
Chronic nophritis
Name of operation
Date of
What test confirmed diagnosis?
Was there an autopsy?
20 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
Francis A. zurko
M. D.
(Address)
Quincy, Mass.
4-26-36
21 PLACE OF BURIAL,
CREMATION OR REMOVAL Winthrop, Mas(iyor town)
DATE OF BURIAL ............
22 NAME OF
Richard .......... White ...
..............
ADDRESS Anthrop Mass
Received and filed. 19
(Registrar of City or Town where deceased resided)
(If U. S.
War Veteran,
specify WAR)
-
13
(Usual place of abode)
St.,
..... .Ward
1 No. (a) 3 SEX Kele AGE Years OCCUPATION PARENTS A TRUE COPY. ATTEST: tion should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. 50m-2-'30. No. 7997-đ N. B .- WRITE PLAINLY, WITH UNFADING INK-THIS IS A PERMANENT RECORD. Every item of informa- (State or country)
this occupation (month and 1924
year)
FEB-11200 MM
R-301A
correctos Copy Mailedto gotero 4/11/39
important. See instructions and extracts from the laws on back of certificate
L
( Signature of count of Board of Health or other ) / Calito Officer
(Official Designation) (Date of Issue of Permits 1/31/39
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
2778,
1939
(Ylear)
19 I HEREBY CERTIFY, Thal I attended deceased from
28,,198,
to
Accu. 286, 1939
I last sawh Leer alive on
fau 2 87, 1939, death is said
to have occurred on the date stated above, at 11:30 Am The principal cause of death and related causes of Importance la order of onset were as follows:
Date of Onset IMPORTANT
Contributory causes of Importance not related to principal cause:
27 Jan-21939
Name of operation
What test confirmed diagnosis?
Was there an autopsy ?.
20 Was disease or Injury in any way related to occupation of deceased?
If so, specify.
tolulplace
(Signed)
M. D.
(Address) 482 VUlarnot Helfen Date 1/301939
21 St. Michaels Boston
Relation if any
Place of Burial, Cremation or Removal
Feb
DATE OF BURIAL
1
(City or Town)
39
-
19 ......
ADDRESS
11 Meridian Str E. T3.
Received and filed.
193X
9
(Registrar)
in plain terms, so that it may be properly classified.
PLACE OF DEATH
Suffolk 20
188 The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
14
Winther of Community Hospital death occurred in a hospital or institution. No. ard (give its NAME instead of street and number) quale Precetti (If U. S. War Veteran
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
St.,
.Ward,
East Boston
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred - year. mooths - days.
How loog in U.S., if of foreign hirth?
years . mooths ~ days."
(write the word)
PARENTS
13 NAME OF
FATHER
Gaetano Tresutti
14 BIRTHPLACE OF
FATHER (City)
East Boston
(State or country)
wass,
15 MAIDEN NAME
OF MOTHER
Elvira Ture
16 BIRTHPLACE OF
MOTHER (City)
Gast 8300 bou
(State or country)
-class,
17 Pactono Presutti (father
Informant
(Address)
124 Frevelt St. E./S.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
22 NAME OF
FUNERAL DIRECTOR
......
24.
Kelly
L .....
19
Date of.
...
Winthrop
1
(City or Town)
2 FULL NAME
(a) Residence.
No ..
124 Everett
(Usual place of abode)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
White
Male
5 SINGLE
Shingle
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
....
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
Stillborn
7
If less than 1 day
8 Trade, profession, or particular
kind of work done, as spinner,
sawyer, bookkeeper, etc ....
9 Industry or business In which
Date of onset and exact statement of OCCUPATION are very
work was done, as silk mill,
saw mill, bank, etc ....
10 Date deceased last worked at
11 Total time (years)
-
spent in this
OCCUPATION
occupation ....
this occupation (month and
year)
......
Winterof
class.
12 BIRTHPLACE (City).
(State or country)
Age should be stated LAAvILl. THISICIANS should state CAUSE OF DEATH
AGE
.Years.
.. Months
Days
.. Hours ............ Minutes
(Day)
Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pur- suits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from bus- iness, report the occupation prior to retirement. Children not gainfully employed may be returned as AT SCHOOL Of AT HOME. For a woman whose only occupation was that of home housework, write HOUSEWORK in answer to Question 8 and OWN HOME in answer to Question 9. For a person engaged in domestic service for wages, however. designate the occupation by the appropriate terms, as HOUSEKEEPER-PRIVATE FAMILY, COOK-HOTEL, etc. For a person who had no occupation whatever write NONE.
To be complete, an occupation return must state :
8 .- The trade, profession, or particular kind of work done.
9 .- The industry or business in which the work was done.
10 .- The month and year the deceased last worked at the occupation.
11 .- The number of years the deceased followed the occupation.
In stating the occupation, avoid the use of such indefinite terms as "employee." "worker," "operative," etc. Find out the partic- ular kind of work done and return that, as SPINNER, WEAVER, etc.
In stating the industry or business, avoid the use of such gen- eral terms as "store," "factory," "mill," etc. State the particular kind of store, factory, mill, etc., as GROCERY STORE, SOAP FACTORY, COTTON MILL, etc.
.Distinguish carefully the different. kinds of engineers by stating the full descriptive titles, as CIVIL ENGINEER, MECHANICAL ENGIN- ZER, MINING ENGINEER, STATIONARY ENGINEER, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic," hut give the exact occupation, as CARPENTER, PAINTER, MACHINIST, etc. Distinguish carefully between RETAIL MERCHANTS AND WHOLESALE MERCHANTS. A person who sells goods should be called a SALESMAN and not a CLERK.
Statement of Cause of Death. - Cause of death means the disease, or complication which causes death, NOT the mode of dying, E. G .. heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.
Example
'The principal cause of death and related causes of importance in order of onset were as follows:
Date of Omset
Arteriosclerosis
1915
Chronic interstitial nepbritis
1921
Cerebral hemorrhage
July 5. 1927
Contributory causes of importance not related to principal cause :
In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first. second. or third position. The principal cause in the above example happens to be the second cause given.
GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth- with, atter the death of a person whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his sup- posed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . . GEN. LAWS, CHAP. 46, SEC. 9.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person · died ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the casc may bc, a satisfactory written statement con- taining the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as re- quired by law, or in lieu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot be obtained early enough for the pur- pose. or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attend- ing physician. If death is caused by violence, the medical cxaminer shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was re- moved within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital. as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the I'nited States in any war in which it has been engaged, such recital shall ap- pear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith counter. sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician cer- tifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death. which the clerk or registrar may require .- CHAP. 114, SEC. 45,, G. L. (TER- CENTENARY EDITION.)
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. . .-- GEN. LAWS, CHAP. 38, SEC. 6.
..... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .-- GEN. LAWS. CHAP. 38, SEC. 7.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . .-- CHAP. 114, SEC. 46, G. L. (TERCENTENARY EDITION.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ob- servance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deathis caused directly or indirectly by traumatism (including resulting septi- cemia), and by the action of chemical (drugs or poisons). thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation. the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
M R-303 B
SullCk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. Registered No.
15
(If death occurred in a hospital or institution, give its NAME instead of street and number)
Raymond Francis Doucette
(If U. S. War Veteran,
specify WAR)
(If nonresident, give city or town and state)
Length of residence in city or town where death occurred yTS.
mos.
days.
How long in U. S., if of foreign birth?
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
1
5 SINGLE
(write the word)
White
MARRIED
WIDOWED
or DIVORCED Married
idowedon diroradorrow Doucette
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 IF STILLBORN, enter that fact here.
AGE Years .Months .Days
If less than 1 day Hours. .Minutes
8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. Shipper
9 Industry or business in which work was done, as silk mill, Howe &French
10 Date deceased last worked at
11 Total time (years)
this occupation (mopir? an1939
year)
occupation.
Yarmouth
spent in this 6mos.
12 BIRTHPLACE (City)
(State or country)
N.S
13 NAME OF
FATHER
Theodore Doucette
(State or country) Nova Scotia
15 MAIDEN NAME
OF MOTHER
Cannot Be Learned
(State or country) Nova Scotia
17
Informant
Emily Doucette
(Address) 143 Sewall Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial.or transit permit was issued:
(Signature of trenght board of Health or other) Health offices (Date of Issue of Permit) 1/30/39
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January 28 -1939
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